Jun Hamano1, Masanori Mori2, Taketoshi Ozawa3, Jun Sasaki4, Masanori Kawahara5, Asumi Nakamura6, Kotaro Hashimoto7, Kazuhiro Hisajima8, Tomoyuki Koga9, Keiji Goto10, Kazuhiko Fukumoto11, Yuri Morimoto12, Masahiro Goshima13, Go Sekimoto14, Mika Baba15, Kiyofumi Oya16, Ryo Matsunuma17, Yukari Azuma18, Kengo Imai19, Tatsuya Morita20, Takuya Shinjo21. 1. Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 2. Seirei Mikatahara General Hospital, Shizuoka, Japan. 3. Megumi Zaitaku Clinic, Yokohama, Japan. 4. Yushoukai Medical Corporation, Tokyo, Japan. 5. Soshukai Okabe Clinic Sendai, Miyagi, Japan. 6. Himawari Clinic, Chiba, Japan. 7. Fukushima Home Palliative Care Clinic, Fukushima, Japan. 8. Dr. GON Kamakura Clinic, Kanagawa, Japan. 9. Nozominohana Clinic, Chiba, Japan. 10. Himawari clinic, Kumamoto, Japan. 11. Iwata Home Care Clinic, Shizuoka, Japan. 12. Morimoto Clinic, Hyogo, Japan. 13. Home care clinic Kobe, Hyofo, Japan. 14. Sekimoto Clinic, Hyogo, Japan. 15. Department of Palliative Medicine, Suita Tokushukai Hospital, Suita, Japan. 16. Department of Palliative and Supportive Care, Aso Iizuka Hospital, Fukuoka, Japan. 17. Department of Palliative Medicine, Kobe University Graduate school of Medicine, Hyogo, Japan. 18. Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 19. Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan. 20. Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan. 21. Shinjo-clinic, Hyogo, Japan.
Abstract
BACKGROUND: Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancer patients between inpatient palliative care and palliative home care on admission and at 3 days before death. METHODS: This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancer patients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017. RESULTS: In total, 2998 patients were enrolled and 2829 were analyzed in this study: 1883 patients in PCUs and 947 patients in palliative home care. The prevalence of agitated delirium between PCUs and palliative home care was 5.2% (95% CI: 4.2% - 6.3%) vs. 1.4% (0.7% - 2.3%) on admission (p < 0.001) and 7.6% (6.4% - 8.9%) vs. 5.4% (4.0% - 7.0%) 3 days before death (p < 0.001). However, multivariate logistic regression analysis revealed that the place of care was not significantly associated with the prevalence of agitated delirium at 3 days before death after adjusting for prognostic factors, physical risk factors, and symptoms. CONCLUSIONS: There was no significant difference in the prevalence of agitated delirium at 3 days before death between inpatient palliative care and palliative home care after adjusting for the patient background, prognostic factors, symptoms, and treatment.
BACKGROUND:Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancerpatients between inpatient palliative care and palliative home care on admission and at 3 days before death. METHODS: This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancerpatients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017. RESULTS: In total, 2998 patients were enrolled and 2829 were analyzed in this study: 1883 patients in PCUs and 947 patients in palliative home care. The prevalence of agitated delirium between PCUs and palliative home care was 5.2% (95% CI: 4.2% - 6.3%) vs. 1.4% (0.7% - 2.3%) on admission (p < 0.001) and 7.6% (6.4% - 8.9%) vs. 5.4% (4.0% - 7.0%) 3 days before death (p < 0.001). However, multivariate logistic regression analysis revealed that the place of care was not significantly associated with the prevalence of agitated delirium at 3 days before death after adjusting for prognostic factors, physical risk factors, and symptoms. CONCLUSIONS: There was no significant difference in the prevalence of agitated delirium at 3 days before death between inpatient palliative care and palliative home care after adjusting for the patient background, prognostic factors, symptoms, and treatment.
Authors: Jared R Robbins; Omar H Gayar; Mark Zaki; Meredith Mahan; Thomas Buekers; Mohamed A Elshaikh Journal: Gynecol Oncol Date: 2013-10-11 Impact factor: 5.482
Authors: Fliss Em Murtagh; Christina Ramsenthaler; Alice Firth; Esther I Groeneveld; Natasha Lovell; Steffen T Simon; Johannes Denzel; Ping Guo; Florian Bernhardt; Eva Schildmann; Birgitt van Oorschot; Farina Hodiamont; Sabine Streitwieser; Irene J Higginson; Claudia Bausewein Journal: Palliat Med Date: 2019-06-12 Impact factor: 4.762